PHYTOTHERAPEUTIC COMPOUNDS IN DIABETES MANAGEMENT: A COMPARATIVE ANALYSIS OF NATURAL EXTRACTS AND SYNTHETIC DRUGS

Abstract

This study directly engages a critical practice gap in contemporary type 2 diabetes management by systematically evaluating the comparative effectiveness of phytotherapeutic regimens against conventional antihyperglycemic medications within real-world outpatient settings. As treatment decisions increasingly reflect a personalized balance between metabolic outcomes, medication tolerability, patient adherence, and lived usability, there remains a lack of rigorous comparative evidence on whether botanical therapies—either alone or in combination with standard synthetic drugs—offer clinically meaningful advantages. The primary purpose of this investigation was to determine whether phytotherapy, administered as a standalone regimen or as an adjunct to evidence-based pharmaceuticals, is associated with superior glycemic control and enhanced patient-reported outcomes when compared to synthetic therapy alone. To address this objective, a quantitative, cross-sectional, multi-case analytical design was implemented across five geographically distributed outpatient clinics providing standardized diabetes care. The final sample consisted of 782 adult participants with clinically diagnosed type 2 diabetes who had been maintained on a stable treatment regimen for a minimum duration of six months, ensuring physiological equilibrium and mitigating acute treatment-transition effects. The conceptual framework was informed by a targeted literature synthesis of 44 peer-reviewed empirical studies, which guided variable selection, validated construct definitions, and underpinned instrument reliability. The statistical analysis plan involved multi-tiered modeling procedures. Combination therapy involving standardized phytotherapeutic agents administered alongside guideline-recommended synthetic medications produced significantly lower adjusted HbA1c levels and increased odds of meeting the <7% target compared to synthetic therapy alone. Importantly, phytotherapy-only regimens achieved comparable glycemic performance relative to synthetic monotherapy yet demonstrated markedly superior tolerability and patient-reported satisfaction. Regression mediation analysis demonstrated that each one-point increase in adherence score was associated with clinically meaningful reductions in HbA1c, indicating that adherence partially mediated the enhanced effectiveness of combination therapy These findings substantively contribute to the evidence base by demonstrating that quality-assured botanical formulations, when integrated within conventional therapeutic frameworks, can deliver dual advantages—improved metabolic outcomes and enhanced patient acceptability—without compromising clinical safety.